Background: Considering the importance of oral care in the ICU and the lack of comprehensive protocols for oral care, the present study was conducted to review the available literature on oral care and to present an evidence-based protocol for oral care in ICU patients.

Materials and Methods: Fifty-four full-texts original articles, systematic reviews and meta-analysis papers on mouth care in ICU patients published from 2001 to the end of 2010 in English and indexed in the Pubmed, Ovid, Elsevier, and ProQuest databases were searched by using the relative key-words (e.g. oral care, mouth care, critical care, and intensive care) in the title or abstract and then evaluated.

Results: ICU patients are prone to dental plaque and VAP due to conditions such as impaired immunological deficiency, the presence of an endotracheal tube, drug side effects, and difficulty with swallowing food and fluids. Due to the lack of a standard protocol for oral care in ICU, oral cares haven't properly done in ICU wards. Studies have shown that some oral care interventions (e.g. tooth brushing with toothpaste, brushing all surfaces of teeth, tongue and palate, and also the use of chlorhexidine solution) have largely reduced the incidence of VAP in ICU patients.

Conclusion: The results revealed that the oral hygiene may reduce the incidence of VAP. Hence assessing patients, implementing mechanical and pharmaceutical interventions are important in oral care and applying the protocol presented in this study can improve the oral health of patients in the ICU.